This commentary critically discusses China’s debate on health care reform during 2005-09 and analyses the politics involved. It examines a key point of contention – the ﬁnancing of the health sector – given that the contention has been permeated with politics (who gets what, how and when) and that ﬁnancing has an extremely critical impact on the performance of a health system. The debate on health care ﬁnancing reﬂects two major changes brought by health care privatisation since the late 1980s, namely the changed incentives and behaviour of public hospitals and physicians, and the growing problem of eﬀective management of the health workforces by the government. The commentary is organised as follows. First, it reviews the background of health care reform. Secondly, it studies the debate on how the government should ﬁnance the health sector. The third section discusses the changed incentives and behaviour of public hospitals and physicians and the growing problem of eﬀective management of the health workforces and highlights how these two developments hinder health care reform. The ﬁnal part concludes.